Abstract 2324
Background
Combined HCC-CCA is rare malignancy with incidence of less than 5% of primary hepatic malignancies. Because combined HCC-CCA has been excluded in clinical trials for either HCC or CCA, optimal systemic chemotherapy regimen has not been defined yet for combined HCC-CCA. Therefore, we analyzed efficacy of systemic chemotherapy in patients with unresectable or metastatic combined HCC-CCA.
Methods
Among patients with histologically confirmed combined HCC-CCA from 1999 to 2015 in Asan Medical Center, Seoul, Korea, 120 patients who received systemic chemotherapy for unresectable or metastatic disease were identified and included in this analysis. Overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) were retrospectively evaluated.
Results
15 patients had initially metastatic disease and the other 105 patients had recurrent or progressive disease after local therapy. Sorafenib (n = 69, 56.7%), gemcitabine plus cisplatin (GP) (n = 21, 17.5%), 5-FU-based chemotherapy (n = 22, 19.2%) were most frequently used regimens. Overall, ORR was 10.8%, and median PFS and OS was 4.2 (95% CI 3.0-5.5) and 9.0 months (7.0-11.1), respectively with median follow-up of 39.6 months (24.8-54.3). ORR, PFS and OS did not differ according to chemotherapy regimens (ORR, 7.2%, 13.7% and 18.2%, p = 0.30; median PFS, 4.6 [95% CI 3.8-5.4], 3.7 [1.8-5.6] and 7.9 months [0.5-15.2], p = 0.67; and median OS, 9.8 [7.5-12.1], 8.8 [6.8-10.8], and 8.8 months [4.9-12.7], p = 0.62 in patients with sorafenib, GP, and 5-FU-based chemotherapy, respectively). In univariate analysis, elevated baseline carcinoembryonic antigen (CEA) level, liver cirrhosis (LC) and large tumor burden (≥30% of liver volume) were significantly associated with poorer OS, and these remained significant in multivariate analysis (HR 2.29, 95% CI, 1.26-4.14, p = 0.006 for elevated CEA level; HR 1.67, 1.03-2.70, p = 0.04 for LC; HR 4.75, 2.22-10.16, p < 0.001 for large tumour burden).
Conclusions
Patients with advanced HCC-CCA treated with systemic chemotherapy showed poor prognosis. Further clinical trials to understand biology of combined HCC-CCA and find optimal systemic agents are needed.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3330 - Tumour-infiltrating lymphocytes and BRCA-like status in stage III breast cancer patients treated with intensified carboplatin-based chemotherapy
Presenter: Leonora De Boo
Session: Poster Display session 2
Resources:
Abstract
3971 - Unravelling the biological characteristics of MammaPrint extreme risk subgroups
Presenter: Rajith Bhaskaran
Session: Poster Display session 2
Resources:
Abstract
5871 - Residual Cancer burden as a prognostic factor in a large series of Neoadjuvant chemotherapy. Subgroup analysis per molecular surrogated subtypes
Presenter: Catalina Falo
Session: Poster Display session 2
Resources:
Abstract
5014 - Clinical validation of CanAssist Breast in a Spanish cohort
Presenter: Manjiri Bakre
Session: Poster Display session 2
Resources:
Abstract
2787 - Meta-analysis on association of pathological complete response with long-term survival outcomes in triple-negative breast cancer
Presenter: Peter A. Fasching
Session: Poster Display session 2
Resources:
Abstract
4301 - Immune infiltrate composition across intrinsic subtypes in hormone receptor (HR)+/HER2- early breast cancer (BC) enrolled in the prospective LETLOB trial
Presenter: Gaia Griguolo
Session: Poster Display session 2
Resources:
Abstract
3205 - Frequency of germline mutations in women's cancer susceptibility genes in a large cohort of Chinese breast cancer patients
Presenter: Ning Liao
Session: Poster Display session 2
Resources:
Abstract
4091 - Triple blinded Prospective Study assessing the Impact of Genomics & Artificial Intelligence Watson For Oncology (WFO) on MDT’s Decision of Adjuvant Systemic Therapy for Hormone Receptor Positive Early Breast Carcinoma-
Presenter: Somashekhar Sampige Prasannakumar
Session: Poster Display session 2
Resources:
Abstract
4359 - Prognostic significance of Progesterone Receptor levels in luminal-like Her2- early Breast Cancer patients. A retrospective single Cancer Center analysis.
Presenter: Anna Diana
Session: Poster Display session 2
Resources:
Abstract
1369 - PAM50 HER2-enriched subtype and pathological complete response in HER2-positive early breast cancer: a meta-analysis
Presenter: Francesco Schettini
Session: Poster Display session 2
Resources:
Abstract